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Mathematical modeling study reveals sustained measles transmission in infants, indicating that reaching global vaccination targets remains insufficient to suppress outbreaks.
Bangladesh experienced its worst measles outbreak since 2005 in March–April 2026, with 79%of cases in children under five, driven by falling measles-rubella coverage from 88.6%/89%(2019) to 86%/80.7% (2023). We formulate a two-age-class SEIRV model for a closed 0–24month cohort approximating Bangladesh’s EPI schedule and derive a cohort-restricted controlreproduction number Rc ≈1.93 via the exact spectral radius of the next-generation matrix. Weestablish demographic well-posedness, local and global stability of the disease-free equilibrium, and existence of a positive endemic equilibrium with numerically supported uniqueness.A Latin Hypercube Sampling/PRCC analysis of eight parameters identifies MCV1 coverageand the recovery rate as dominant drivers of Rc, peak burden, and cumulative onset of infectiousness. A 48.2% reduction in effective susceptibility would bring Rc to 1; Rc stays above 1(about 1.07) even under the WHO 2030target. Age-disaggregated simulation and a growth-ratecheck against outbreak data support these conclusions. [submitted]
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Ananna et al. (2026) studied this question.
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